胆管刷检活检与细针穿刺活检在胆管狭窄诊断中的比较。

Comparison of biliary brush biopsy and fine needle biopsy in the diagnosis of biliary strictures.

作者信息

Gonzalez-Aguirre Adrian, Covey Anne M, Brown Karen T, Brody Lynn A, Boas F Edward, Sofocleous Constantinos T, Maybody Majid, Getrajdman George I, Erinjeri Joseph P

机构信息

a Interventional Radiology Service , Memorial Sloan-Kettering Cancer Center , New York , NY , USA.

出版信息

Minim Invasive Ther Allied Technol. 2018 Oct;27(5):278-283. doi: 10.1080/13645706.2018.1427597. Epub 2018 Feb 1.

DOI:10.1080/13645706.2018.1427597

PMID:29390936

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8514154/

Abstract

PURPOSE

The purpose of this study is to evaluate the accuracy of percutaneous fine needle biopsy (FNB) and brush biopsy (BB) at a cancer center.

MATERIAL AND METHODS

Retrospective analysis of all bile duct biopsies performed in Interventional Radiology between January 2000 and January 2015 was performed. FNB was performed under real-time cholangiographic guidance using a notched needle directed at the bile duct stricture. BB was performed by advancing a brush across the stricture and moving it back and forth to scrape the stricture. Biopsy results were categorized as true positive (TP), true negative (TN), false positive (FP) and false negative (FN) based on pathology reports and confirmed by surgical specimens or clinical follow-up of at least six months. Fisher's exact test was used to compare the rate of TP in FNB and BB.

RESULTS

One-hundred and nineteen patients underwent FNB or BB. Fifteen were censored because of lack of follow-up. The remaining 104 patients underwent a total of 117 bile duct biopsies during the study period: 34 FNB and 83 BB. There were no complications in either group. In the FNB group 22/34 (64%) biopsies were TP, 4/34(12%) were TN and there were 8(24%) FN biopsies. In the BB group, 20/83 (24%) were TP, 38/83 (46%) TN and 25/83 (30%) FN biopsies. There were no FP biopsies in either group. The sensitivity of detecting malignancy by FNB was significantly higher than that by BB (73% vs 44%, p < .0005). There were no complications associated with FNB or BB.

CONCLUSIONS

FNB of bile duct strictures is safe and has a higher sensitivity for detecting malignancy than BB.

摘要

目的

本研究旨在评估某癌症中心经皮细针穿刺活检（FNB）和刷检活检（BB）的准确性。

材料与方法

对2000年1月至2015年1月间介入放射科进行的所有胆管活检进行回顾性分析。FNB在实时胆管造影引导下，使用带缺口的针针对胆管狭窄部位进行操作。BB则是将刷子穿过狭窄部位并来回移动以刮擦狭窄处。根据病理报告，活检结果分为真阳性（TP）、真阴性（TN）、假阳性（FP）和假阴性（FN），并通过手术标本或至少六个月的临床随访进行确认。采用Fisher精确检验比较FNB和BB中TP的发生率。

结果

119例患者接受了FNB或BB检查。15例因缺乏随访而被剔除。其余104例患者在研究期间共进行了117次胆管活检：34次FNB和83次BB。两组均未出现并发症。FNB组中，34次活检中有22次（64%）为TP，4次（12%）为TN，8次（24%）为FN活检。BB组中，83次活检中有20次（24%）为TP，38次（46%）为TN，25次（30%）为FN活检。两组均无FP活检。FNB检测恶性肿瘤的敏感性显著高于BB（73%对44%，p <.0005）。FNB或BB均未出现并发症。